Question Grid

Name

qg_8

Label

8

Question Text

Please complete the information given below about the child's absences during the past year.

Information from School Absence Record: Period of Absence: From Information from School Absence Record: Period of Absence: To Information from School Absence Record: Reason for Absence Please give these additional details: If child was ill: Where treated Hospital I.P. Hospital O.P. Nursing Home Own Home Please give these additional details: If child was ill: If treated at home who gave treatment? (Doctor Chemist Nurse, Other) Please give these additional details: Remarks
Generic textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric text Generic textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric text Generic textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric text Generic textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric text Generic textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric text Generic textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric text
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Usage

50 questions before...
Please give the following details about each Clinic attended.
Name of School Clinic or Out-Patient Dept. Reason for attending Date of FIRST attendance (month and year) Date of LAST attendance (month and year) (If still attending strike through) Number of attendances Present condition

1 - cured

2 - improved

3 - unchanged

4 - worse

How manyGeneric textGeneric textGeneric dateGeneric dateHow manyGeneric textGeneric date

1 - cured

2 - improved

3 - unchanged

4 - worse

Generic textGeneric dateGeneric dateGeneric dateGeneric textGeneric text

1 - cured

2 - improved

3 - unchanged

4 - worse

How manyGeneric textHow manyGeneric textGeneric dateGeneric date

1 - cured

2 - improved

3 - unchanged

4 - worse

1 - cured

2 - improved

3 - unchanged

4 - worse

Generic dateHow manyGeneric textGeneric textGeneric dateGeneric textGeneric textGeneric dateGeneric dateHow many

1 - cured

2 - improved

3 - unchanged

4 - worse

1 - cured

2 - improved

3 - unchanged

4 - worse

How manyGeneric textGeneric textGeneric dateGeneric dateHow manyGeneric textGeneric date

1 - cured

2 - improved

3 - unchanged

4 - worse

Generic textGeneric dateGeneric dateGeneric dateGeneric textGeneric text

1 - cured

2 - improved

3 - unchanged

4 - worse

How manyGeneric textHow manyGeneric textGeneric dateGeneric date

1 - cured

2 - improved

3 - unchanged

4 - worse

1 - cured

2 - improved

3 - unchanged

4 - worse

Generic dateHow manyGeneric textGeneric textGeneric dateGeneric textGeneric textGeneric dateGeneric dateHow many

1 - cured

2 - improved

3 - unchanged

4 - worse

1 - cured

2 - improved

3 - unchanged

4 - worse

How manyGeneric textGeneric textGeneric dateGeneric dateHow manyGeneric textGeneric date

1 - cured

2 - improved

3 - unchanged

4 - worse

Generic textGeneric dateGeneric dateGeneric dateGeneric textGeneric text

1 - cured

2 - improved

3 - unchanged

4 - worse

How manyGeneric textHow manyGeneric textGeneric dateGeneric date

1 - cured

2 - improved

3 - unchanged

4 - worse

1 - cured

2 - improved

3 - unchanged

4 - worse

Generic dateHow manyGeneric textGeneric textGeneric dateGeneric textGeneric textGeneric dateGeneric dateHow many

1 - cured

2 - improved

3 - unchanged

4 - worse

1 - cured

2 - improved

3 - unchanged

4 - worse

How manyGeneric textGeneric textGeneric dateGeneric dateHow manyGeneric textGeneric date

1 - cured

2 - improved

3 - unchanged

4 - worse

Generic textGeneric dateGeneric dateGeneric dateGeneric textGeneric text

1 - cured

2 - improved

3 - unchanged

4 - worse

How manyGeneric textHow manyGeneric textGeneric dateGeneric date

1 - cured

2 - improved

3 - unchanged

4 - worse

1 - cured

2 - improved

3 - unchanged

4 - worse

Generic dateHow manyGeneric textGeneric textGeneric dateGeneric textGeneric textGeneric dateGeneric dateHow many

1 - cured

2 - improved

3 - unchanged

4 - worse

1 - cured

2 - improved

3 - unchanged

4 - worse

How manyGeneric textGeneric textGeneric dateGeneric dateHow manyGeneric textGeneric date

1 - cured

2 - improved

3 - unchanged

4 - worse

Generic textGeneric dateGeneric dateGeneric dateGeneric textGeneric text

1 - cured

2 - improved

3 - unchanged

4 - worse

How manyGeneric textHow manyGeneric textGeneric dateGeneric date

1 - cured

2 - improved

3 - unchanged

4 - worse

1 - cured

2 - improved

3 - unchanged

4 - worse

Generic dateHow manyGeneric textGeneric textGeneric dateGeneric textGeneric textGeneric dateGeneric dateHow many

1 - cured

2 - improved

3 - unchanged

4 - worse

1 - cured

2 - improved

3 - unchanged

4 - worse

How manyGeneric textGeneric textGeneric dateGeneric dateHow manyGeneric textGeneric date

1 - cured

2 - improved

3 - unchanged

4 - worse

Generic textGeneric dateGeneric dateGeneric dateGeneric textGeneric text

1 - cured

2 - improved

3 - unchanged

4 - worse

How manyGeneric textHow manyGeneric textGeneric dateGeneric date

1 - cured

2 - improved

3 - unchanged

4 - worse

1 - cured

2 - improved

3 - unchanged

4 - worse

Generic dateHow manyGeneric textGeneric textGeneric dateGeneric textGeneric textGeneric dateGeneric dateHow many

1 - cured

2 - improved

3 - unchanged

4 - worse

1
2
Please complete the information given below about the child's absences during the past year.
Information from School Absence Record: Period of Absence: From Information from School Absence Record: Period of Absence: To Information from School Absence Record: Reason for Absence Please give these additional details: If child was ill: Where treated Hospital I.P. Hospital O.P. Nursing Home Own Home Please give these additional details: If child was ill: If treated at home who gave treatment? (Doctor Chemist Nurse, Other) Please give these additional details: Remarks
Generic textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric text Generic textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric text Generic textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric text Generic textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric text Generic textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric text Generic textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric text
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Is the child now dry by day ?

0
Never wet
1
Sometimes wet
39 questions after...
View the complete instrument

Dimensions

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False
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True

Code Dimension

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Display Label
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